Level 3
Med-Surg HESI | 2026/2027 Final Exam Study Guide
Section 1: Cardiovascular & Hematology (20 Questions)
,1. What is the priority nursing assessment for a client receiving IV heparin for a pulmonary
embolism?
a) Monitor for signs of infection at the IV site.
b) Assess for signs of bleeding and check aPTT levels. ✓
c) Evaluate for hypertension and tachycardia.
d) Listen for crackles in the lung fields.
2. A client with heart failure is prescribed furosemide (Lasix). Which finding indicates the
medication is effective?
a) Increased urine output and decreased dyspnea. ✓
b) A rise in blood pressure.
c) Decreased heart rate to 50 bpm.
d) Weight gain of 2 pounds in a day.
3. The nurse notes a new, irregular heart rhythm on the telemetry monitor for a client with an
acute myocardial infarction (MI). What is the priority action?
a) Call a code blue.
b) Assess the client’s level of consciousness and vital signs. ✓
c) Prepare for cardioversion.
d) Administer the next dose of metoprolol early.
4. Which instruction is most important for a client with permanent atrial fibrillation taking
warfarin (Coumadin)?
a) "Take your medication on an empty stomach."
b) "Use a soft-bristle toothbrush and electric razor." ✓
c) "Increase your intake of green, leafy vegetables."
d) "Avoid all over-the-counter cold medications."
5. A client with a deep vein thrombosis (DVT) suddenly reports chest pain and shortness of
breath. What should the nurse suspect first?
a) Pneumonia.
b) Pulmonary embolism. ✓
c) Anxiety attack.
d) Myocardial infarction.
6. Which client is at greatest risk for developing infective endocarditis?
a) A 25-year-old with asthma.
b) A 45-year-old with a prosthetic heart valve. ✓
c) A 60-year-old with osteoarthritis.
d) A 70-year-old with hypertension.
,7. The nurse is teaching a client about taking nitroglycerin for angina. Which statement by the
client indicates understanding?
a) "I should take up to three tablets, 5 minutes apart, and call 911 if pain persists." ✓
b) "I will lie down for 30 minutes after taking the pill."
c) "I can store my pills in the bathroom medicine cabinet."
d) "A headache means I am allergic to the medication."
8. Which lab result is most critical to monitor for a client receiving a blood transfusion?
a) Serum potassium.
b) Hemoglobin and hematocrit.
c) Serum creatinine.
d) Temperature and blood pressure. ✓
9. A client with sickle cell anemia is admitted in crisis. What is the priority nursing
intervention?
a) Administer high-flow oxygen.
b) Initiate aggressive IV hydration and pain management. ✓
c) Apply warm compresses to painful joints.
d) Encourage deep breathing exercises.
10. What is a hallmark sign of cardiac tamponade?
a) Widening pulse pressure.
b) Distended neck veins, hypotension, and muffled heart sounds (Beck's triad). ✓
c) Bradycardia and hypertension.
d) Productive cough with pink frothy sputum.
11. A post-op client has a hemoglobin of 7.2 g/dL. Which symptom requires immediate
intervention?
a) Pallor.
b) Fatigue.
c) Tachycardia and shortness of breath at rest. ✓
d) Cool skin.
12. Which diet is most appropriate for a client with Stage 2 hypertension?
a) Low-sodium, DASH diet. ✓
b) High-protein, low-carbohydrate diet.
c) Full liquid diet.
d) Regular diet with added potassium.
, 13. Before administering digoxin, the nurse must assess:
a) Blood pressure.
b) Apical heart rate for one full minute. ✓
c) Respiratory rate.
d) Capillary refill.
14. A client with aortic stenosis should be taught to avoid:
a) High-fiber foods.
b) Isometric exercises like heavy lifting. ✓
c) Walking programs.
d) Fluids.
15. Which finding is a late sign of hypovolemic shock?
a) Anxiety and restlessness.
b) Tachycardia.
c) Unconsciousness and profound hypotension. ✓
d) Decreased urine output.
16. Priority teaching for a client on clopidogrel (Plavix) is:
a) Report any signs of unusual bleeding or black, tarry stools. ✓
b) Take the medication with food to avoid GI upset.
c) Avoid all direct sunlight.
d) Check pulse daily.
17. After a cardiac catheterization via the right femoral artery, it is essential to:
a) Keep the leg straight and check the site for bleeding/hematoma. ✓
b) Assist the client to ambulate within 2 hours.
c) Apply a heating pad to the site for comfort.
d) Encourage coughing and deep breathing.
18. A client with heart failure should report which symptom immediately?
a) Weight gain of 3 lbs or more in one day. ✓
b) Occasional dry cough at night.
c) Mild ankle edema in the evening.
d) Feeling tired after exertion.
19. The therapeutic INR range for a standard client on warfarin is:
a) 1.0 - 1.5
b) 2.0 - 3.0 ✓
Med-Surg HESI | 2026/2027 Final Exam Study Guide
Section 1: Cardiovascular & Hematology (20 Questions)
,1. What is the priority nursing assessment for a client receiving IV heparin for a pulmonary
embolism?
a) Monitor for signs of infection at the IV site.
b) Assess for signs of bleeding and check aPTT levels. ✓
c) Evaluate for hypertension and tachycardia.
d) Listen for crackles in the lung fields.
2. A client with heart failure is prescribed furosemide (Lasix). Which finding indicates the
medication is effective?
a) Increased urine output and decreased dyspnea. ✓
b) A rise in blood pressure.
c) Decreased heart rate to 50 bpm.
d) Weight gain of 2 pounds in a day.
3. The nurse notes a new, irregular heart rhythm on the telemetry monitor for a client with an
acute myocardial infarction (MI). What is the priority action?
a) Call a code blue.
b) Assess the client’s level of consciousness and vital signs. ✓
c) Prepare for cardioversion.
d) Administer the next dose of metoprolol early.
4. Which instruction is most important for a client with permanent atrial fibrillation taking
warfarin (Coumadin)?
a) "Take your medication on an empty stomach."
b) "Use a soft-bristle toothbrush and electric razor." ✓
c) "Increase your intake of green, leafy vegetables."
d) "Avoid all over-the-counter cold medications."
5. A client with a deep vein thrombosis (DVT) suddenly reports chest pain and shortness of
breath. What should the nurse suspect first?
a) Pneumonia.
b) Pulmonary embolism. ✓
c) Anxiety attack.
d) Myocardial infarction.
6. Which client is at greatest risk for developing infective endocarditis?
a) A 25-year-old with asthma.
b) A 45-year-old with a prosthetic heart valve. ✓
c) A 60-year-old with osteoarthritis.
d) A 70-year-old with hypertension.
,7. The nurse is teaching a client about taking nitroglycerin for angina. Which statement by the
client indicates understanding?
a) "I should take up to three tablets, 5 minutes apart, and call 911 if pain persists." ✓
b) "I will lie down for 30 minutes after taking the pill."
c) "I can store my pills in the bathroom medicine cabinet."
d) "A headache means I am allergic to the medication."
8. Which lab result is most critical to monitor for a client receiving a blood transfusion?
a) Serum potassium.
b) Hemoglobin and hematocrit.
c) Serum creatinine.
d) Temperature and blood pressure. ✓
9. A client with sickle cell anemia is admitted in crisis. What is the priority nursing
intervention?
a) Administer high-flow oxygen.
b) Initiate aggressive IV hydration and pain management. ✓
c) Apply warm compresses to painful joints.
d) Encourage deep breathing exercises.
10. What is a hallmark sign of cardiac tamponade?
a) Widening pulse pressure.
b) Distended neck veins, hypotension, and muffled heart sounds (Beck's triad). ✓
c) Bradycardia and hypertension.
d) Productive cough with pink frothy sputum.
11. A post-op client has a hemoglobin of 7.2 g/dL. Which symptom requires immediate
intervention?
a) Pallor.
b) Fatigue.
c) Tachycardia and shortness of breath at rest. ✓
d) Cool skin.
12. Which diet is most appropriate for a client with Stage 2 hypertension?
a) Low-sodium, DASH diet. ✓
b) High-protein, low-carbohydrate diet.
c) Full liquid diet.
d) Regular diet with added potassium.
, 13. Before administering digoxin, the nurse must assess:
a) Blood pressure.
b) Apical heart rate for one full minute. ✓
c) Respiratory rate.
d) Capillary refill.
14. A client with aortic stenosis should be taught to avoid:
a) High-fiber foods.
b) Isometric exercises like heavy lifting. ✓
c) Walking programs.
d) Fluids.
15. Which finding is a late sign of hypovolemic shock?
a) Anxiety and restlessness.
b) Tachycardia.
c) Unconsciousness and profound hypotension. ✓
d) Decreased urine output.
16. Priority teaching for a client on clopidogrel (Plavix) is:
a) Report any signs of unusual bleeding or black, tarry stools. ✓
b) Take the medication with food to avoid GI upset.
c) Avoid all direct sunlight.
d) Check pulse daily.
17. After a cardiac catheterization via the right femoral artery, it is essential to:
a) Keep the leg straight and check the site for bleeding/hematoma. ✓
b) Assist the client to ambulate within 2 hours.
c) Apply a heating pad to the site for comfort.
d) Encourage coughing and deep breathing.
18. A client with heart failure should report which symptom immediately?
a) Weight gain of 3 lbs or more in one day. ✓
b) Occasional dry cough at night.
c) Mild ankle edema in the evening.
d) Feeling tired after exertion.
19. The therapeutic INR range for a standard client on warfarin is:
a) 1.0 - 1.5
b) 2.0 - 3.0 ✓
